title: Surgical procedures, complications, and prognosis for gastric cancer in the very elderly (>85): a retrospective study.
abstract: Many elderly individuals suffer from reduced functioning of major organs with cardiovascular and respiratory system comorbidity. Consequently, surgical stress and postoperative complications can be fatal. We investigated whether gastrectomy can safely improve the prognosis in very elderly (>85 years) patients with gastric cancer. We compared the clinical and pathological features of patients 85 years and older (Group A) with those 80- to 84-year-old (Group B) who underwent gastrectomy. We also compared the survival rates of Group A and Group B, and investigated the prognostic factors. Group A had a high incidence of patients with 3 or more comorbidities, but these did not influence postoperative complications or survival rate. Patients at stage I or II had a significantly higher survival rate than those who did not undergo surgery. However, there was no statistical difference in survival rate at stage III or IV. Our study results revealed that in the early stages (I and II) of well-differentiated gastric cancer with low risk of lymph node metastasis, surgery should consist of minimal lymphadenectomy and be minimally invasive. Further, treatments other than gastrectomy should be considered for patients in whom complete resection via reduction surgery is not possible.
authors.affiliation: Department of Surgery, Kurume University School of Medicine, Japan. taro_isobe@yahoo.co.jp
authors.forename: Taro
authors.initials: T
authors.lastname: Isobe
authors.forename: Kousuke
authors.initials: K
authors.lastname: Hashimoto
authors.forename: Junya
authors.initials: J
authors.lastname: Kizaki
authors.forename: Motoshi
authors.initials: M
authors.lastname: Miyagi
authors.forename: Keishiro
authors.initials: K
authors.lastname: Aoyagi
authors.forename: Kikuo
authors.initials: K
authors.lastname: Koufuji
authors.forename: Kazuo
authors.initials: K
authors.lastname: Shirouzu
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy / Q000379:methods; D006801:Humans; D007564:Japan; D008207:Lymphatic Metastasis; D008297:Male; D009362:Neoplasm Metastasis; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome